Cardiac rhythm interpretation and
dysrhythmia care
150 practice questions with answer rationales
COURSE Cardiac rhythms and dysrhythmias
QUESTIONS 150
PREPARED August 2026
,Cardiac rhythms and dysrhythmias
Exam Overview
This academic exam resource gives Nursing School a focused 150-question practice set for Cardiac
rhythms and dysrhythmias. The material is written to support careful review, practical reasoning, and
steady preparation without promotional claims or repeated title wording. Questions use clear
professional language, credible answer choices, and concise rationales that help students understand
why one option is best. The document provides high-quality academic material for independent
revision, classroom reinforcement, and identifying knowledge gaps before assessments. Students
should pair it with course notes, textbooks, instructor guidance, and current academic standards for
the strongest preparation. Each item supports careful review, confident practice, and.
Question 1: Which pathway correctly describes normal cardiac electrical conduction?
A. SA node ? bundle of His ? AV node ? bundle branches ? Purkinje fibers
B. AV node ? SA node ? Purkinje fibers ? bundle branches ? bundle of His
C. Bundle branches ? SA node ? AV node ? Purkinje fibers ? bundle of His
D. SA node ? AV node ? bundle of His ? bundle branches ? Purkinje fibers
Answer: D
Rationale: The impulse normally starts in the SA node and follows the AV node, His bundle, bundle
branches, then Purkinje fibers.
Question 2: Which finding is expected in normal sinus rhythm?
A. No visible P waves
B. Irregularly irregular QRS complexes
C. Each QRS is usually preceded by a P wave
D. Wide, bizarre QRS complexes
Answer: C
Rationale: Normal sinus rhythm has a consistent atrial impulse with a P wave before each QRS.
Question 3: A patient has a heart rate of 118/min, normal P waves, and regular rhythm.
What rhythm is most likely?
A. Sinus bradycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Sinus tachycardia
Answer: D
Rationale: A regular rhythm with normal P waves and a rate over 100/min is sinus tachycardia.
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,Cardiac rhythms and dysrhythmias
Question 4: Which ECG pattern is most consistent with atrial fibrillation?
A. Regular rhythm with peaked P waves
B. Sawtooth flutter waves
C. No discernible P waves and an irregularly irregular rhythm
D. ST elevation in contiguous leads
Answer: C
Rationale: Atrial fibrillation typically has no distinct P waves and an irregularly irregular ventricular
response.
Question 5: Which rhythm description best fits atrial flutter?
A. Irregularly irregular rhythm with no P waves
B. Sinus rhythm with prolonged PR interval only
C. Wide-complex rhythm with no atrial activity
D. Sawtooth atrial activity with a regular ventricular response
Answer: D
Rationale: Atrial flutter is classically associated with sawtooth flutter waves and often a regular
conducted ventricular rate.
Question 6: What is the hallmark of first-degree AV block?
A. Dropped QRS complexes after some P waves
B. Absent P waves
C. PR interval longer than 0.20 second
D. QRS duration greater than 0.12 second
Answer: C
Rationale: First-degree AV block is defined by a prolonged PR interval, with every P wave
conducted.
Question 7: Which ECG finding is required to identify sinus rhythm rather than an atrial
dysrhythmia?
A. No P waves present on the tracing
B. A wide QRS complex greater than 0.12 second
C. An irregularly irregular R-R interval
D. A visible P wave before every QRS complex
Answer: D
Rationale: Sinus rhythm originates in the SA node, so each impulse should produce a P wave
followed by a QRS complex. Irregularly irregular intervals and absent P waves are more consistent
with atrial fibrillation, while a wide QRS suggests a ventricular conduction problem.
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, Cardiac rhythms and dysrhythmias
Question 8: Which ECG finding is most consistent with third-degree AV block?
A. PR interval over 0.20 second
B. Progressive PR prolongation
C. P waves unrelated to QRS complexes
D. Short PR interval with delta wave
Answer: C
Rationale: Complete heart block has atrioventricular dissociation, so atrial and ventricular rhythms
are independent.
Question 9: A premature ventricular contraction is typically seen as which ECG pattern?
A. Prolonged PR interval with every beat
B. Early narrow QRS complex with visible P wave
C. Regular sawtooth waves
D. Early wide QRS complex without a preceding P wave
Answer: D
Rationale: PVCs originate in the ventricle, so they are usually wide and occur early without a
preceding P wave.
Question 10: A telemetry strip shows a regular rhythm at 168/min with wide, bizarre QRS
complexes and no clearly discernible P waves. Which rhythm is most consistent with this
pattern?
A. Accelerated idioventricular rhythm
B. Junctional tachycardia
C. Atrial flutter with 2:1 conduction
D. Ventricular tachycardia
Answer: D
Rationale: A fast, regular rhythm with wide QRS complexes and absent visible P waves is
characteristic of ventricular tachycardia. Atrial flutter and junctional tachycardia usually have narrow
QRS complexes unless another conduction problem is present.
Question 11: Which rhythm is most consistent with pulseless ventricular tachycardia?
A. Narrow QRS with irregularly irregular rhythm
B. Isolated premature atrial beats
C. Sinus rhythm with rate of 90/min
D. Regular wide-complex tachycardia with no palpable pulse
Answer: D
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dysrhythmia care
150 practice questions with answer rationales
COURSE Cardiac rhythms and dysrhythmias
QUESTIONS 150
PREPARED August 2026
,Cardiac rhythms and dysrhythmias
Exam Overview
This academic exam resource gives Nursing School a focused 150-question practice set for Cardiac
rhythms and dysrhythmias. The material is written to support careful review, practical reasoning, and
steady preparation without promotional claims or repeated title wording. Questions use clear
professional language, credible answer choices, and concise rationales that help students understand
why one option is best. The document provides high-quality academic material for independent
revision, classroom reinforcement, and identifying knowledge gaps before assessments. Students
should pair it with course notes, textbooks, instructor guidance, and current academic standards for
the strongest preparation. Each item supports careful review, confident practice, and.
Question 1: Which pathway correctly describes normal cardiac electrical conduction?
A. SA node ? bundle of His ? AV node ? bundle branches ? Purkinje fibers
B. AV node ? SA node ? Purkinje fibers ? bundle branches ? bundle of His
C. Bundle branches ? SA node ? AV node ? Purkinje fibers ? bundle of His
D. SA node ? AV node ? bundle of His ? bundle branches ? Purkinje fibers
Answer: D
Rationale: The impulse normally starts in the SA node and follows the AV node, His bundle, bundle
branches, then Purkinje fibers.
Question 2: Which finding is expected in normal sinus rhythm?
A. No visible P waves
B. Irregularly irregular QRS complexes
C. Each QRS is usually preceded by a P wave
D. Wide, bizarre QRS complexes
Answer: C
Rationale: Normal sinus rhythm has a consistent atrial impulse with a P wave before each QRS.
Question 3: A patient has a heart rate of 118/min, normal P waves, and regular rhythm.
What rhythm is most likely?
A. Sinus bradycardia
B. Atrial fibrillation
C. Ventricular tachycardia
D. Sinus tachycardia
Answer: D
Rationale: A regular rhythm with normal P waves and a rate over 100/min is sinus tachycardia.
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,Cardiac rhythms and dysrhythmias
Question 4: Which ECG pattern is most consistent with atrial fibrillation?
A. Regular rhythm with peaked P waves
B. Sawtooth flutter waves
C. No discernible P waves and an irregularly irregular rhythm
D. ST elevation in contiguous leads
Answer: C
Rationale: Atrial fibrillation typically has no distinct P waves and an irregularly irregular ventricular
response.
Question 5: Which rhythm description best fits atrial flutter?
A. Irregularly irregular rhythm with no P waves
B. Sinus rhythm with prolonged PR interval only
C. Wide-complex rhythm with no atrial activity
D. Sawtooth atrial activity with a regular ventricular response
Answer: D
Rationale: Atrial flutter is classically associated with sawtooth flutter waves and often a regular
conducted ventricular rate.
Question 6: What is the hallmark of first-degree AV block?
A. Dropped QRS complexes after some P waves
B. Absent P waves
C. PR interval longer than 0.20 second
D. QRS duration greater than 0.12 second
Answer: C
Rationale: First-degree AV block is defined by a prolonged PR interval, with every P wave
conducted.
Question 7: Which ECG finding is required to identify sinus rhythm rather than an atrial
dysrhythmia?
A. No P waves present on the tracing
B. A wide QRS complex greater than 0.12 second
C. An irregularly irregular R-R interval
D. A visible P wave before every QRS complex
Answer: D
Rationale: Sinus rhythm originates in the SA node, so each impulse should produce a P wave
followed by a QRS complex. Irregularly irregular intervals and absent P waves are more consistent
with atrial fibrillation, while a wide QRS suggests a ventricular conduction problem.
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, Cardiac rhythms and dysrhythmias
Question 8: Which ECG finding is most consistent with third-degree AV block?
A. PR interval over 0.20 second
B. Progressive PR prolongation
C. P waves unrelated to QRS complexes
D. Short PR interval with delta wave
Answer: C
Rationale: Complete heart block has atrioventricular dissociation, so atrial and ventricular rhythms
are independent.
Question 9: A premature ventricular contraction is typically seen as which ECG pattern?
A. Prolonged PR interval with every beat
B. Early narrow QRS complex with visible P wave
C. Regular sawtooth waves
D. Early wide QRS complex without a preceding P wave
Answer: D
Rationale: PVCs originate in the ventricle, so they are usually wide and occur early without a
preceding P wave.
Question 10: A telemetry strip shows a regular rhythm at 168/min with wide, bizarre QRS
complexes and no clearly discernible P waves. Which rhythm is most consistent with this
pattern?
A. Accelerated idioventricular rhythm
B. Junctional tachycardia
C. Atrial flutter with 2:1 conduction
D. Ventricular tachycardia
Answer: D
Rationale: A fast, regular rhythm with wide QRS complexes and absent visible P waves is
characteristic of ventricular tachycardia. Atrial flutter and junctional tachycardia usually have narrow
QRS complexes unless another conduction problem is present.
Question 11: Which rhythm is most consistent with pulseless ventricular tachycardia?
A. Narrow QRS with irregularly irregular rhythm
B. Isolated premature atrial beats
C. Sinus rhythm with rate of 90/min
D. Regular wide-complex tachycardia with no palpable pulse
Answer: D
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